In patients with heart failure and a preserved ejection fraction, clinical medication trials have failed to show benefits in mortality. From January 1996 to May 2016, for a study, the researchers searched Medline, Embase, and the Cochrane Central Register of Controlled Trials for RCTs evaluating pharmacological therapies in patients with heart failure with a left ventricular (LV) ejection fraction of more than or equal to 40%. All-cause death was the major efficacy outcome. Cardiovascular mortality, heart failure hospitalization, exercise ability (6-minute walk distance, exercise duration, VO2 max), quality of life, and biomarkers were all secondary outcomes (B-type natriuretic peptide, N-terminal pro-B-type natriuretic peptide). Pooled relative risks (RR) for binary outcomes and weighted mean differences for continuous outcomes were estimated using random-effects models with 95% confidence intervals. The researchers used information from 25 RCTs with a total of 18101 subjects. When compared to placebo, beta-blocker medication reduced all-cause mortality (RR:0.78, 95% Confidence interval 0.65 to 0.94, P=0.008). ACE inhibitors, aldosterone receptor blockers, mineralocorticoid receptor antagonists, and other medication types had no impact when compared to placebo. Similar outlines were determined in the case of cardiovascular mortality. When compared to placebo, no single drug class reduced heart failure hospitalization. Treatment efficacy varies depending on the kind of therapy used in patients with heart failure and an LV ejection fraction of more than or equal to 40%, with beta-blockers showing a reduction in all-cause and cardiovascular mortality. More research is needed to confirm the therapeutic effects of beta-blockers in the patient population.
Link:pubmed.ncbi.nlm.nih.gov/28780577/
